History of the present illness

This is a 62-year-old male who presented complaining of “pain and swelling" in his left cheek.  The patient was prescribed antibiotics for one week.  Clinically, the swelling was not in the soft tissue but involved the angle of the mandible and part of the ramus.  A panoramic radiograph revealed a large, corticated and unilocular radiolucency in the left mandibular angle and ramus (Figure 1).  The radiolucency was surrounded by reactive bone formation.  The patient’s past medical history is significant for one-pack-per-day cigarette smoking and Hepatitis C diagnosed nine years ago.

Figure 1 Panoramic view at first presentation demonstrating large unilocular radiolucency with corticated border involving angle of the mandible and part of the ramus.